The Nature of Orthodontic Problems and Malocclusion

Evolution of Orthodontics

Angel’s Molar Classification

The focus of modern orthodontic treatment is on improving not only dental and skeletal but also soft tissue aspects of orthodontic problems, in combination with other dental treatment as needed.

Malocclusion Any deviation from the ideal occlusal scheme

Epidemiology of Malocclusion Ideal occlusion as defined by Angle is a rare occurance 65% of the US population present some type of malocclusion

Crowding Space required by the dentition for all teeth to be aligned normally exceeds the space available in the dental arch. Rotations, incisor irregularity etc.

What percentage of the population presents with severe crowding?

About 15-20% Crowding increases with age Is worst in the lower arch

Overjet Horizontal overlap of incisors Approx 2mm is considered normal

Malocclusion What is the prevalence of severe overjet ? (> 6mm)

Malocclusion 5 – 10% Correlates with the prevalence of Class II malocclusion

What is the prevalence of negative overjet? Malocclusion What is the prevalence of negative overjet?

Malocclusion Less than 1% in the US Is a characteristic of Class III malocclusions Much more prevalent in Japan and China

Overbite Overbite is the vertical overlap of incisors. 1-2mm overbite is considered normal. Excessive overbite is called deep bite >5mm overbite is considered severed deep bite Overbite <0mm is called an open bite

Malocclusion Deep bites are more prevalent in which ethnic group? Black White

Malocclusion Open bites are more prevalent in blacks Deep bites are more prevalent in whites

Posterior Crossbite Maxillary posterior teeth are lingually positioned to mandibular posterior teeth. Discrepancy in the widths of maxillary and mandibular arches. Can arise from dental causes as well

How many patients in a typical US population have a posterior crossbite?

Is very similar between whites, blacks and hispanics About 10 % Is very similar between whites, blacks and hispanics

Diastema A space between two adjacent teeth is called a diastema. Maxillary midline diastema is most commonly seen in mixed dentition phase

Malocclusion Which ethnic group has the higher prevalence of midline diastemas White Black Hispanic

Malocclusion Blacks have double the prevalence of anterior diastema compared to whites

Department of Orthoodnitcs Assigned reading Contemporary Orthodontics: Chapter 1 Pg 3-22 Bhoomika Ahuja Department of Orthoodnitcs bahuja@umaryland.edu Room 3213